Summary

Presumptive diagnosis of allergic rhinitis may be made in the presence of nasal congestion, sneezing, and itchy nose/palate/eyes with a pattern of allergic triggers.

Definitive diagnosis would require specific IgE reactivity during skin-prick or in vitro testing, but a trial of therapy may be ordered on the basis of a presumptive clinical diagnosis.

Treatment consists of allergen avoidance where possible and pharmacotherapy (antihistamines, corticosteroids, cromolyn, decongestants, leukotriene receptor antagonists). Immunotherapy may be an option in patients with persistent symptoms.

Intranasal corticosteroids remain the single most effective class of medications for treating allergic rhinitis.

Reducing exposure to environmental allergens (e.g., dander, dust mite, potten, and tobacco smoke) is an important measure for patients sensitive to these items, and can often be recommended empirically based on the patient's history.

Definition

Allergic rhinitis (AR) is a common yet under-appreciated inflammatory condition of the nasal mucosa, characterized by nasal pruritus, sneezing, rhinorrhea, and nasal congestion, the last of which is often deemed the most bothersome symptom. Frequently, there is associated palate, throat, ear, and eye itching as well as eye redness, puffiness, and watery discharge. AR is mediated by an IgE-associated response to ubiquitous indoor and/or outdoor environmental allergens.

Disclosures

Disclosures

GS is a consultant/advisory board member for ALK, Britannia Pharmaceuticals, CMP Therapeutics, Groupo Uriach, GSK, Merck, Sanofi-Aventis, Schering Plough, and UCB. She has received research funds from ALK, GSK, UCB, and Schering Plough. She has given talks for ALK, GSK, Merck, Schering Plough, and UCB and has co-written articles for Schering Plough and GSK.